Heterogeneous multicopy of bla<sub>CTX-M</sub> variants on the same plasmid enhances evolutionary adaptability in clinical Klebsiella pneumoniae.

Weng, Rui; Zhu, Jingyi; Wu, Xueqing; Shi, Qiucheng; Li, Yue; Zhou, Junxin; Wang, Yanfei; Wang, Yinping et al. · Nat Commun · 2026

basic_science · Level V

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Abstract

Pathogenic bacteria continually evolve under antimicrobial pressure through acquired resistance genes, making it crucial to understand their evolutionary strategies. We identify a clinical Klebsiella pneumoniae isolate resistant to ceftazidime/avibactam (CZA), harboring heterogeneous multicopy bla<sub>CTX-M</sub>, among which a bla<sub>CTX-M-249</sub> variant mediates CZA resistance. Both bla<sub>CTX-M-249</sub> and its closely related allele bla<sub>CTX-M-65</sub> are dominant within the clonal population and are located at two loci on the same plasmid, with their proportions shifting under antibiotic pressure. Using experimental and mathematical models, we demonstrate that the heterogeneous arrangement of bla<sub>CTX-M</sub> variants on the same plasmid confers greater stability and competitive advantage than that across separate plasmids, particularly during drug switching. Re-analysis of large genomic datasets supports the universality of this phenomenon. Our findings reveal an evolutionary strategy in which β-lactamase genes, through multicopy heterogeneity on a single plasmid, ensure stable inheritance of resistance and enhance bacterial adaptability under fluctuating clinical antibiotic pressures.

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